Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA.
J Epidemiol Community Health. 2013 May;67(5):405-11. doi: 10.1136/jech-2012-201008. Epub 2013 Jan 15.
Dysregulated emotional functioning has been linked with higher cardiovascular disease (CVD) risk among adults. Early life experiences may influence the development of adulthood CVD, but few studies have examined whether potential damaging effects of dysregulated emotional function begin earlier in life. Therefore, we examined associations of child emotional functioning and the 10-year risk of developing CVD in midlife.
We studied 377 adult offspring (mean age=42.2) of Collaborative Perinatal Project participants, a US cohort of pregnant women enrolled in 1959-1966. Three measures of child emotional functioning derived from psychologist ratings of behaviour at 7 years of age were examined: distress proneness, attention and inappropriate self-regulation. Adulthood 10-year CVD risk was calculated with the validated Framingham general CVD risk algorithm. Gender-specific multiple regression models assessed associations of childhood emotion and adulthood CVD risk independent of covariates measured across the life course. Potential mediators of the associations were also examined.
Women had 31% higher CVD risk per SD increase in childhood distress proneness (p=0.03) and 8% reduced risk per SD increase in attention (p=0.09). For men, each SD increase in childhood distress proneness was associated with 17% higher CVD risk (p=0.02). Associations were partly explained by adulthood body mass index and depressive symptoms in women but not in men. Inappropriate self-regulation was not associated with CVD risk.
Several aspects of childhood emotional functioning was associated with adulthood CVD risk, particularly for women. As such, primary prevention of CVD may be associated with addressing early life emotional functioning.
情绪功能失调与成年人患心血管疾病(CVD)的风险增加有关。早期生活经历可能会影响成年期 CVD 的发展,但很少有研究探讨情绪功能失调的潜在破坏性影响是否更早开始出现。因此,我们研究了儿童情绪功能与中年时期 CVD 发病风险的 10 年相关性。
我们研究了美国科罗拉多州科罗拉多大学健康科学中心的 377 名合作围产期项目参与者的成年子女(平均年龄为 42.2 岁),该参与者为 1959-1966 年期间参与的孕妇队列。使用心理学家在 7 岁时对行为进行评估的三种儿童情绪功能指标进行了研究:易苦恼、注意力和不适当的自我调节。使用经过验证的 Framingham 一般 CVD 风险算法计算成年后 10 年 CVD 风险。性别特异性多元回归模型评估了儿童情绪与成年 CVD 风险之间的关联,这些关联独立于整个生命周期中测量的协变量。还检查了关联的潜在中介因素。
女性儿童易苦恼每增加一个标准差,CVD 风险增加 31%(p=0.03),注意力每增加一个标准差,CVD 风险降低 8%(p=0.09)。对于男性,儿童易苦恼每增加一个标准差,CVD 风险增加 17%(p=0.02)。在女性中,这些关联部分通过成年人体重指数和抑郁症状来解释,但在男性中则没有。不适当的自我调节与 CVD 风险无关。
儿童情绪功能的几个方面与成年期 CVD 风险有关,尤其是对女性而言。因此,CVD 的一级预防可能与解决早期的情绪功能有关。